Ivyrehab Michigan, LLC

Primary specialty

Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X

Legal business name

IVYREHAB MICHIGAN, LLC

Practice address

400 Rounds Dr
Fenton, MI 48430-1724

Phone

(810) 750-1996

Fax

(810) 750-6361

NPI assigned

Oct 17, 2017

Last updated

Sep 16, 2025By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ashley Griffiths

Title

Sr. Director of Provider Relations

Phone

(914) 294-4050

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Tax ID family

Ivyrehab Michigan LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Ivyrehab Michigan, LLC

  • Behavior Analyst
  • Hartland, MI
  • NPI 1508519489
  NPD tax ID

Locations (25 of 50)

Practitioners 501

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Muath W Abuhammour, PT, DPT

  • Physical Therapist
  • Keego Harbor, MI
  • NPI 1427943026
  Medicare reassignment Care Compare group NPD
• Shelby L Adams, DPT

  • Physical Therapist
  • Caledonia, MI
  • NPI 1538582887
  Medicare reassignment Care Compare group NPD
• Andrea Aliseo, DPT

  • Physical Therapist
  • Ypsilanti, MI
  • NPI 1821539966
  Medicare reassignment Care Compare group NPD
• John Shipman Armstrong, DPT

  • Physical Therapist
  • Belleville, MI
  • NPI 1356781975
  Medicare reassignment Care Compare group NPD
• Norton Bahoura, PT, DPT

  • Physical Therapist
  • West Bloomfield, MI
  • NPI 1962940494
  Medicare reassignment Care Compare group NPD
• Elizabeth Anne Banet, DPT

  • Physical Therapist
  • Lake Orion, MI
  • NPI 1336993054
  Medicare reassignment Care Compare group NPD
• Jenna Belote, DPT

  • Physical Therapist
  • Hudsonville, MI
  • NPI 1598364846
  Medicare reassignment Care Compare group NPD
• Brianne N Benko, DPT

  • Physical Therapist
  • Linden, MI
  • NPI 1710655535
  Medicare reassignment Care Compare group NPD
• Kathryn Elizabeth Blank, PT, DPT

  • Physical Therapist
  • Big Rapids, MI
  • NPI 1023621349
  Medicare reassignment Care Compare group NPD
• Ashley Brauer, DPT

  • Physical Therapist
  • Novi, MI
  • NPI 1043629959
  Medicare reassignment Care Compare group NPD
• Kiara Jane Bromley

  • Physical Therapist
  • Ludington, MI
  • NPI 1033066253
  Medicare reassignment Care Compare group NPD
• Olivia Bruck, DPT

  • Physical Therapist
  • Adrian, MI
  • NPI 1285240564
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1508198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757980800000",
    "number": "1104337120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 MAMARONECK AVE STE 140",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106055224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 ROUNDS DR",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484301724",
            "telephone_number": "810-750-1996",
            "fax_number": "810-750-6361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IVYREHAB MICHIGAN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-17",
        "last_updated": "2025-09-16",
        "certification_date": "2025-09-16",
        "status": "A",
        "authorized_official_last_name": "GRIFFITHS",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "SR. DIRECTOR OF PROVIDER RELATIONS",
        "authorized_official_telephone_number": "914-294-4050"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Innovative Healthcare Solutions, LLC
• Institute for Christian Counseling PC
• Integrated Behavioral Health LLC
• Intentional Wellbeing LLC
• Iris Eyecare PC
• J Flack PSYD PC (Fenton Wellness)
• Belle Jackson
• Jeffrey A. Jacob, P.T.
• Shannon Nicole Jacobs, PHARMD
• James C Reeves, O.D.P.C.

• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Fenton, MI
• Providers in Fenton, MI by specialty
• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.